Program to prolong pregnancies aims to give premature babies a better shot

Monday

Oct 31, 2011 at 12:01 AMOct 31, 2011 at 1:28 PM

Christian Sanders named the baby D'Angel. D'Angel was stillborn at 29 weeks last October. Sanders' placenta had ruptured. Sanders, 28, now is 26 weeks pregnant and is part of a central Ohio effort to help women have longer pregnancies and healthier babies. It is her fervent hope that she will be one of the Better Births Outcomes Collaborative's proud stories.

Misti Crane, The Columbus Dispatch

Christian Sanders named the baby D’A ngel.

D’Angel was stillborn at 29 weeks last October. Sanders’ placenta had ruptured.

Sanders, 28, now is 26 weeks pregnant and is part of a central Ohio effort to help women have longer pregnancies and healthier babies. It is her fervent hope that she will be one of the Better Births Outcomes Collaborative’s proud stories.

She is enrolled in a project in which weekly progesterone shots are given to women at high risk of a preterm delivery, either because they had a previous preemie or a miscarriage.

The collaborative has enrolled 165 women this year, and officials say they are thrilled with the results. The average length of pregnancy for the 126 women who’ve delivered babies is more than 35 weeks, up an average of six weeks and two days over their earliest previous pregnancies.

“For us, even a week is amazing. Every single week is gold for us,” said Dr. Kristina Reber, a neonatologist at Nationwide Children’s Hospital.

Babies born closer to full term have fewer struggles early in life, fewer developmental disabilities and much lower medical bills.

“A 29-weeker is a baby who has to be on a (ventilator). A 36-weeker is a baby that can probably go home with mom,” Reber said. “As much as I like taking care of premature babies, I’d rather not."

Most of the women in the project are on Medicaid or have no insurance. And most of them are black — something that is notable because of the disproportionate incidence of prematurity and infant death among African-Americans, said Dr. Patricia Temple-Gabbe, a Children’s physician.

Almost eight of every 1,000 babies born in Ohio die before their first birthdays, according to state data from 2007. Among black mothers, about 15 of every 1,000 babies die before turning 1 year old.

All of the Columbus-area hospital systems, Columbus Public Health and the Columbus Neighborhood Health Centers are involved in the collaborative. Other efforts that are under way include nurse home visits and gatherings in Weinland Park and the Near East Side, during which women learn about prenatal care and cooking nutritional meals.

The progesterone shots are safe, proven to extend pregnancies and are widely offered to women with private insurance, said Dr. Jay Iams, director of Ohio State University Medical Center’s prematurity clinic.

The shots are not made as available to lower-income women and minorities, said nurse Hetty Walker, the OSU clinic’s coordinator.

“We’re a lot better off than we were even six months ago,” Iams said, “a lot better off than we were a couple of years ago.”

Members of the group are eager to begin other initiatives, including screening women who are first-time moms to see whether they are at risk of premature delivery because of a shortened cervix. They’d also like to expand their progesterone project into southeastern Ohio.

Jeff Klingler, president of the Central Ohio Hospital Council, said hospital leaders are enthusiastic about the work so far and support continued efforts to work together to reduce prematurity.

Sanders, who lives on the Near East Side, gets her prenatal care at the OSU clinic and said she is grateful for the shots and good care. She said the project is important because it will help more mothers understand the risk of repeat premature deliveries.

Before D’Angel, Sanders gave birth to Demonie, who is now 2 years old. He weighed just more than 1?pound at birth and spent more than three months in intensive care.

She also has two daughters, 8-year-old Terri’Onnia and 5-year-old Ja’Onna.

“Maybe if I would have gotten some of the treatment that I’m getting now, I probably would still have my son,” she said.

mcrane@dispatch.com

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